Friday, November 18, 2005

Editor's Note: This commentary originally appeared in a variety of online communities, including Daily Kos. -- Ilona Meagher

This photo was taken on March 25, 2003. Snapped by AP and published in newspapers and magazines world-wide a week following the invasion, Army medic Pfc. Joseph Dwyer carries an injured Iraqi boy to safety.

Caught in the crossfire in a fierce battle near the village of Al Faysaliyah, the lines of hero and victim appear to be well-defined, not blurred.

On October 7, 2005, Dwyer was arrested after a 3 hour standoff with police in which he discharged 'volley after volley' of gunfire in his apartment.

Dwyer (who'd joined the military 2 days after the September 11th terrorist attacks) returned home to accolades -- and to dealing with his post-traumatic stress disorder (PTSD). He had an apparently strong safety net of family, friends, and neighbors. He was well-liked and welcomed home as a hero. Yet, he slid into the horror of PTSD washing over many of our nation's returning veterans.

Pfc. Joseph Dwyer's family wishes to draw attention to the plight of returning vets dealing with PTSD as a result of the war in Iraq. His story, gravely, is one of far too many.

Army Spc. Joseph Dwyer angled a mirror out the back window of his apartment in El Paso, Texas, trying to make out the Iraqis in the evening gloom. He couldn't see them, but he felt that they were out there somewhere, ready to attack.

Holding his 9-mm handgun tight, the 29-year-old medic from Mount Sinai phoned in an air strike using military code. He directed the fighter jets to his own street address. Then he heard a noise from the roof - maybe an Iraqi trying to get in? - and that's when Dwyer began firing.

Dwyer was deep in a delusional state, thinking that he was back in Iraq and under fire. After a 3 hour standoff with police at his apartment (no one was injured), he was arrested on a misdemeanor charge of discharging a firearm in a municipality; made bail; and is currently being treated by Ft. Bliss, Texas, military psychiatrists.

Days earlier:

Concerned about Dwyer's increasingly strange behavior and his use of inhalants to get high, three friends staged an intervention days before the El Paso standoff. They tried unsuccessfully to persuade him to give up his weapons and to get the help he needed.

He knew on some level that they were right, Dwyer said, but he still couldn't do it. "I'm a soldier," he said. "I suck it up. That's our job."

Mission Accomplished

92 days. That's just 3 months.

That's how long Pfc. Joseph Dwyer was in Iraq.

Although his time was short in duration, he was attached temporarily to the 3rd Squadron of the 7th Cavalry Regiment of the 3rd Infantry Division - a unit referred to as `the tip of the spear.' They were scouts out in front of an initial invading division moving forcefully north from Kuwait to Baghdad.

And they saw heavy combat.

"It took 21 days to get to Baghdad," Dwyer said last week, speaking by telephone from the William Beaumont Army Medical Center in Fort Bliss, Texas. "We had four days that we didn't get shot at." Dwyer came back to the United States in June 2003, and visited his family on Long Island on July 4. He seemed happy to be back and easy to laugh, but he was also gaunt and fidgety, said his sister, Christine Dwyer-Ogno, 38, of Mount Sinai. His wife, Matina, declined to comment.

"We didn't think of his mental health," said Dwyer-Ogno. "We were just so glad to have him back in our arms."

That was 2 ½ years ago.

A Changed Man

When he returned home, he was no longer able to do a lot of the normal, everyday things that we all take for granted. He couldn't handle going to the movies or other noisy, crowded spots. At restaurants, he made sure he was in full view of the door and premises. At home, he obsessively scanned the Internet for Iraq war photos - to see if anyone he knew died.

A lot can change in 92 days.

Always a quiet kid, Dwyer enjoyed a happy childhood on Long Island, family members said. Son of a New York City Transit Police lieutenant, Dwyer loved to fish, and he played golf for Mount Sinai High.

He signed up for the Army two days after the Sept. 11, 2001, attacks. At the time, he was was living in North Carolina, working as a transporter at a hospital and considering going into a nursing program. But his plans changed when his older brother, Patrick, lost two close colleagues in the attacks.

"They knocked my towers down," Dwyer said. "So I was ready to go."

Hero and Victim

The photo which was published worldwide in the opening days of the invasion (the one that Dwyer initially hated for the fame it brought him) shows the medic with an injured 4 year old Iraqi boy.

Dwyer went on to treat the boy, named Ali, successfully for a broken leg. Although the photo captured a memorable moment, Dwyer has another memory even more deeply etched into his soul of his days spent in combat:

"To be honest . . . I was embarrassed by it," he said. "I saw so many heroic things like that. It kind of made me stand out as the glory boy, but really it was one team, one fight." ...

Dwyer remembers daylight coming after a night of shooting and his awful realization that there were homes and families in the firing line. He remembers the awkward modesty of Ali's pregnant mother as he checked her for bombs before she was moved to the field hospital. He remembers the quick work of another medic who pulled a piece of shrapnel "the size of a silver dollar" out of Ali's bloody knee.

What Dwyer mentions only in passing is this: During the firefight the night before, a rocket struck the Humvee he was driving. No one was killed, but something fundamental shifted in Dwyer. He started to accept the inevitability of his own death in Iraq.

"That made it easier for me to do my job," he recalls. "It made it harder to think about mom and wife, and them having to bury me, but it made it easier to do my job."

When Dwyer returned to his hero's welcome, he shrugged off what he'd done as simply part of doing his job. When he returned home, he also shrugged off early treatment for PTSD.

Post Traumatic Stress Disorder - Symptoms and Stats

Dwyer is one of many Iraq and Afghanistan veterans who suffer from post-traumatic stress disorder, or PTSD. Known in previous wars as "shell shock" or "combat fatigue," PTSD was identified as a psychiatric disorder in 1980 after its symptoms were seen in returning Vietnam veterans. Those with PTSD often relive the stressful event in nightmares or flashbacks; avoid activities, places, or people that are reminders of the trauma; and have a sense of perpetual vigilance, as if on sentry duty. PTSD is often compounded by substance abuse.

Almost one in six soldiers returning from Iraq have symptoms of PTSD, major depression or anxiety, a study published in July of last year in the New England Journal of Medicine found. If the study, led by Department of Defense researcher Col. Charles W. Hoge, is an accurate predictor, more than 25,000 of the 154,000 who have served in Iraq will have mental health problems. ...

Of those returning Iraq and Afghanistan veterans in last year's study who screened positive for PTSD, depression or anxiety, the majority had received no treatment, the researchers found, with 23 percent to 40 percent reporting that they had. Even more disturbing to the study authors, those who screened positive were twice as likely to report concern about being stigmatized for seeking mental health services - meaning those who most needed help were least likely to seek it.

"This finding may indicate that within the military culture, 'succumbing' to PTSD is seen as a failure, a weakness, and as evidence of an innate deficiency of the right stuff," an editorial accompanying the study said.

Dwyer just wanted to get his life back on track when he returned. The life he'd left behind 92 days earlier. He wasn't interested in wasting any more time -- or maybe he just wanted to blot the memories all away.

The Long Journey Home

Initially, Dwyer was getting no psychiatric treatment, something he blames himself for because, he explained, he faked the post-deployment assessment sheet he filled out on his way home through Kuwait.

"Did you see any dead bodies?" was one of the test questions, he recalled. "Did you fire your weapons?"

The Newsday piece goes on to describe Dwyer's struggle with his post-combat PTSD in greater detail. Dwyer and his family are now hoping to turn some attention to the PTSD struggles of other returning veterans. Dwyer's additional hope is that some day we might live in a time where sons and daughters no longer need to go off to fight in such wars.

He wants to get the word out to his fellow soldiers about PTSD. He'd like them to shed their fears about the stigma, and to get help: "There's a lot of soldiers suffering in silence."

Although his tour of duty is scheduled to end in November, Dwyer said, he will probably extend it to get the treatment he needs. After that, he plans to move to North Carolina to be near his parents and in-laws, and to become a paramedic.

Dwyer is still nervous about the challenges ahead. "I know I don't need to be carrying a weapon," he said. "And I'm scared of going home without having one, even though I know probably nobody's going to attack me."

He thinks sometimes of the children he encountered in war. He has heard that Ali, the little boy from that village by the Euphrates, is walking again. He recalls the giggles of other children he met in Iraq when he let them taste Tabasco sauce from Army-issued meals on the tips of their fingers.

And he thinks of his own child, due next spring. Last week in Texas, he saw the tiny heart beat on an ultrasound device. He hopes he or she does not have to experience a war.

"What would be awesome," he said, "is if they never have to go through that."

While a wide variety of events can trigger what's called post-traumatic stress disorder, this PTSD blog focuses solely on the combat-related variety.
As a new generation of warriors returns to civilian life and seeks out resources, PTSD Combat is here to help.

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Considerable Quotes

"The first shamans earned their keep in primitave societies by providing explanations and rituals that enabled man to deal with his environment and his personal anguish. Early man, no less than we, dealt with forces that he could not understand or control, and he attempted to come to grips with his vulnerablity by trying to bring order to his universe." -- Richard Gabriel in No More Heroes

"War stories end when the battle is over or when the soldier comes home. In real life, there are no moments amid smoldering hilltops for tranquil introspection. When the war is over, you pick up your gear, walk down the hill and back into the world." -- OIF vet John Crawford in The Last True Story I'll Ever Tell

"After wars' end, soldiers once again become civilians and return to their families to try to pick up where they left off. It is this process of readjustment that has more often than not been ignored by society. -- Major Robert H. Stretch, Ph.D in Textbook of Military Medicine: Vol. 6 Combat Stress

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